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Published in:

01-12-2008

Results of Surgical Treatment After Neoadjuvant Chemotherapy for Stage III Non-Small Cell Lung Cancer

Authors: Angelo Carretta, Paola Ciriaco, Giulio Melloni, Imad Sayed, Alessandro Bandiera, Luca Ferla, Armando Puglisi, Piero Zannini

Published in: World Journal of Surgery | Issue 12/2008

Abstract

Background

The potential benefits of an approach combining neoadjuvant chemotherapy and surgery in stage IIIA and IIIB NSCLC have to be weighed against a potential increase in postoperative complications. We evaluated the results in terms of postoperative complications and survival in patients with stage III NSCLC who underwent complete surgical treatment after neoadjuvant chemotherapy with two regimens: mitomycin, vinblastine, and cisplatin (MPV) versus gemcitabine and cisplatin (GC).

Methods

From March 1991 to September 2005, 110 patients with stage III NSCLC (86 stage IIIA and 24 stage IIIB) underwent complete surgical treatment after neoadjuvant chemotherapy. Ninety-two patients were men and 18 were women, with a mean age of 59 (range, 39–80) years. The neoadjuvant chemotherapy regimen was MPV in 72 patients and GC in 38.

Results

The overall response (>50%) to chemotherapy was 84%. Postoperative mortality and morbidity were 1.8% and 20%, respectively. Overall 5-year survival was 46%. Minor response to neoadjuvant chemotherapy (<50%) and residual nodal N2 involvement in stage IIIA had an adverse impact on survival (p < 0.05).

Conclusions

Favorable long-term survival was observed after neoadjuvant chemotherapy with MPV and GC regimens in stage IIIA and IIIB NSCLC, with relatively low postoperative mortality and morbidity. Caution should be taken when offering surgical treatment to patients with minor response to induction chemotherapy and residual N2 disease in view of the significantly reduced survival.

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Title: Results of Surgical Treatment After Neoadjuvant Chemotherapy for Stage III Non-Small Cell Lung Cancer
Authors: Angelo Carretta
Paola Ciriaco
Giulio Melloni
Imad Sayed
Alessandro Bandiera
Luca Ferla
Armando Puglisi
Piero Zannini
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 12/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9774-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Results of Surgical Treatment After Neoadjuvant Chemotherapy for Stage III Non-Small Cell Lung Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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